There are different views on the definition. Some experts believe that it is more correct to use the general name dorsalgia, or nonspecific back pain. Difficulties in definition are also due to the fact that a large number of specialists work with this disease - neurologists, orthopedists, neurosurgeons and general practitioners. Sometimes a person diagnosed with osteochondrosis of the spine turns to a cardiologist, since the manifestations of the disease are very similar to pain in the heart.
The term "osteochondrosis of the spine" was proposed by Hildebrandt in 1933 as a multifactorial degenerative disease of the movement segment of the spine
Spinal osteochondrosis is a pathological process in the spine characterized by degenerative-destructive disorders of the vertebrae and intervertebral discs. The danger of the disease lies in the hidden course of the process; upon admission, patients enter the stage of complications, where severe pain begins.
Causes of osteochondrosis
Osteochondrosis of the spine occurs due to the influence of predisposing factors on the human body. The disease does not differ by gender. Triggers for the development of osteochondrosis:
- heredity;
- back injuries;
- congenital or acquired defects in the structure of the musculoskeletal system (flat feet, changes in posture);
- Metabolic disorders caused by diseases of the internal secretory organs;
- poor diet and obesity;
- viral and bacterial infections;
- Lifestyle: lifting and carrying heavy objects, working in drafts, constant exposure to vibration, physical inactivity;
- constant psycho-emotional overload;
- bad habits: smoking, alcohol, opiates.
Osteochondrosis of the spine: types
Osteochondrosis of the spine is divided according to the extent of damage. Each type has its own specifics and treatment features.
Osteochondrosis of the lumbar spine.
The most common back disease is osteochondrosis of the lumbar spine, which is associated with severe stress on this region. Susceptible to complications such as protrusion of intervertebral discs and the occurrence of single or multiple hernias. If complications arise, dysfunction of the pelvic organs and atrophy of the muscles of the lower extremities may occur.
Osteochondrosis of the cervical spine
Second place in the classification of back diseases. Pathological processes arise due to a sedentary lifestyle and increased load on the shoulder girdle. The neck muscles require special training, without which they simply cannot cope with the load due to their poor development.
Osteochondrosis of the thoracic spine
The rarest pathology of the back due to the low mobility of the region and the most developed muscular corset. Due to the long asymptomatic course and similarity to other diseases (coronary artery disease, intercostal neuralgia, pulmonary diseases), diagnosis is difficult.
Joint process
The pathology covers several departments at once, occurs rarely and against the background of congenital diseases of the musculoskeletal system and is practically untreatable.
Stages of osteochondrosis and possible complications
A description of the four stages of spinal osteochondrosis was proposed by Osna in 1971. They are not intended to make a diagnosis, but rather allow us to understand the course of the disease.
- Intervertebral discs become less elastic. The intervertebral disc may be slightly deformed; the inner nucleus pulposus shifts within the intervertebral disc. This stage either does not manifest itself at all, or mild pain occurs.
- In the second stage, tears can occur in the intervertebral disc and the surrounding ligaments become weakened. The connection between the vertebrae becomes unstable. Acute attacks of pain occur with limited ability to work.
- The third stage is characterized by complete damage to the intervertebral disc. When the nucleus pulposus protrudes beyond the disc, a herniated disc occurs. Spinal deformities or pinched nerve roots can occur.
- In the fourth stage, surrounding tissues are affected - vertebrae, ligaments, spinal membranes. This can cause the spinal segment to completely lose its mobility.
In some cases, various complications arise as a result of spinal osteochondrosis. Problems with discs, herniated discs, and bulges can lead to narrowing of the spinal canal, compression of the spinal cord, and disability.
Depending on the extent of the damage, various problems with nerve root involvement are possible. These include intercostal neuralgia, sensory and motor disorders of the upper and lower extremities and dysfunction of internal organs. Inflammation of the sciatic nerve, or sciatic nerve, not only causes severe pain but can also lead to pelvic disease and infertility.
In addition to the nerve roots, osteochondrosis can cause compression of the vertebral vessels. If the blood flow to the vertebral arteries that run in the neck and supply the brain is impaired, brain disorders, vision or hearing problems, breathing or heart problems can occur.
Diagnosis of osteochondrosis
In official medicine, the diagnosis of osteochondrosis includes an examination by a neurologist to determine the extent of damage to the nerve roots, as well as an examination of reflexes and sensitivity.
The following instrumental methods can be used:
- Vascular ultrasound can reveal the degree of circulatory disorder, for example in the vertebral arteries;
- X-ray of the spine;
- CT also uses X-ray methods, but allows you to create a three-dimensional image of the examined area and detect even small displacements of the vertebrae;
- MRI specializes in the examination of soft tissues and allows assessing the condition of the spinal cord and visualizing the internal structure of the intervertebral disc.
Laboratory tests, general blood and urine tests, and calcium metabolism tests are used for differential diagnosis.
The treatment of osteochondrosis is complex.
- The first and very important means in the treatment of osteochondrosis is lifestyle. Normalization of working conditions, moderate and regular exercise, and healthy sleep significantly improve the condition of patients.
- For the medical treatment of spinal osteochondrosis, a neurologist or general practitioner can prescribe medication. Non-steroidal anti-inflammatory drugs are most often prescribed - this is the standard treatment for spinal osteochondrosis. They relieve pain and reduce inflammation. Muscle relaxants help reduce muscle spasms. To protect nerve tissue from damage, vitamins and antioxidants are prescribed. However, every medicine has side effects, for example NSAIDs can have a negative effect on the stomach.
- In addition to medication, physiotherapy is also used, for example massage for spinal osteochondrosis, as well as manual therapy. In severe complications of osteochondrosis, surgical intervention may be required, but it is prescribed only if long-term conservative treatment does not have any effect.